Chronic Lymphocytic Leukemia (CLL)

Chronic Lymphcytic leukemia (CLL) is condition caused due to lymphocytes losing their normal perishing capability leading to their accumulation over periods of time. Initially, the cell production amplifies solely in the blood, however as years pass by, they tend to proliferate even in the lymph nodes, liver, spleen and bone marrow.

Chronic Lymphocytic Leukemia Symptoms:

• Several patients are asymptomatic during analysis, apart from a high white blood cell count.
• Few might experience weariness or lymph node swelling or a sense abdominal fullness because of a spleen enlargement.
• As CLL reaches more advanced stages and commences replacing normal bone marrow, the depleted blood counts could lead to one becoming anemic and prone to infections. CLL makes a person more susceptible to infection due to sapped antibodies (gamma globulin) production that posess bacteria-combatant property.
• In 5-10% of the cases, CLL leads to self-annihilation of the patient’s own red blood cells and/or platelets by an ‘autoimmune process’. Platelet obliteration is known as ITP or immune thrombocytopenic purpura and red blood cell annihilation is known as AHA or autoimmune haemolytic anemia.

Diagnosis & Tests:

Chronic lymphocytic leukemia (CLL) is detected by the surge in the white blood cell count comprised chiefly of small lymphocytes. The diagnosis is corroborated by ‘immunophenotyping’ or flow cytometry procedure that reveals coexpression of the CD19 and CD5 markers. CLL is one form of leukemia that has a recognized staging system:

• RAI Stages (0 to I) – In this initial phase of the disease, there is soaring lymphocyte count and swollen lymph nodes.
• RAI Stage II – In this intermediary phase, the spleen shows enlargement.
• RAI Stages (III – IV) – In the final stage of the disease, there is a disturbance in the bone marrow function and a major depletion in the red blood cell and platelet counts.

Among 5-10% of the patients, The CLL could modify to become a belligerent lymphoma known as Richter’s syndrome.

Chronic Lymphocytic Leukemia Treatment:

Majority of the patients having initial-stage chronic lymphocytic leukemia or CLL would not require any form of treatment on diagnosis of the disease. On an average such patients would survive for more than a decade and prompt treatment would not proffer any significant benefits. Treatment is ideally commenced when either a later stage of the disease has been detected or during an intermediary stage with major symptoms, increased lymph node enlargement or a swift rise in the lymphocyte count that is observed to double in less than a year’s time.

Chemotherapy

The most prevalent CLL treatment is the use of the chemotherapy drug fludarabine that is administered intravenously for 5 days in a week during the month prolonging for 4-6 months. Though the schedule for administering fludarabine is quite inopportune, it is known to lead to reticent side effects like weariness. Majority of the patients would respond positively to this form of treatment and continue to exhibit lower levels of the disease for 2-3 years. Chlorambucil, an orally taken chemotherapy drug might additionally be given as a substitute to fludarabine, particularly in older or weak patients.

Trial Treatments

There are numerous new-fangled treatments presently undergoing testing that includes:

• The deployment of other forms of chemotherapy drugs like cyclophos-phamide and Cytoxan merged with fludarabine for observing if this raises the efficacy of the treatment.
• The inclusion of the antibody treatment using rituxirnab (Rituxan).
• The usage of the investigational antibody Campath IH that emerges to be another effectual treatment method.

Additionally, allogeneic stem cell transplantation, additionally known as bone marrow transplantation, could be used as a potential means of curing CLL. This treatment is solely employed for treating the infrequent younger age bracket patients that have belligerent CLL, as majority of the patients having CLL survive that far that the risk of undergoing transplant could rarely be necessary.

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